Regenerative Peripheral Nerve Interfaces for the Management of Symptomatic Non-extremity Neuropathic Pain and Neuromas.

Introduction: Regenerative peripheral nerve interfaces (RPNI) can be used to mitigate neuropathic pain resulting from nerve injury or neuroma formation following trauma, surgery, or amputation. Most of the current literature discusses the utility of RPNI for the treatment of neuropathic pain in the upper and lower extremities; however, RPNI can also improve neuropathic pain in non-extremity regions. Our objective was to characterize and describe patient cases of non-extremity RPNIs.

Methods: We retrospectively reviewed medical records of patients treated with RPNIs for non-extremity neuropathic pain by the senior author at a single institution between February 2020 and October 2023.

Cases: Seven patients were treated with RPNI in non-extremity regions. For 1 patient, RPNI was performed prophylactically following discovery of injured peripheral nerves during a surgery and the patient did not report any neuropathic pain in the related regions afterwards. Six patients presented with nerve pain in multiple regions, including the scalp, face, trunk, and groin, that began either after a trauma or previous surgery. The nerve pain of 5 patients completely resolved after the creation of an RPNI.

Discussion: The creation of an RPNI is relatively straightforward and can relieve or prevent peripheral nerve pain caused by injured nerves. While RPNIs have mainly been used for the treatment or prevention of neuromas in extremities, this case series demonstrates efficacy in non-extremity areas as well. Surgeons can, therefore, consider RPNI for patients who have neuropathic pain due to suspected nerve injury that has been refractory to other treatments.